Chinese Medical Sciences Journal最新文献

{"title":"Effects of Sevoflurane and Propofol on Neurological Recovery of Traumatic Brain Injury Patients in the Early Postoperative Stage: A Retrospective Cohort Study","authors":"Bei Wu ,&nbsp;Wan-Qing Song ,&nbsp;Jin-Qian Dong ,&nbsp;Hong-Li Yue ,&nbsp;Yu Lu ,&nbsp;Yun Yu ,&nbsp;Shu-Yu Hao ,&nbsp;Bai-Yun Liu ,&nbsp;Wei-Hua Cui","doi":"10.24920/004188","DOIUrl":"10.24920/004188","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the effects of propofol and sevoflurane on neurological recovery of traumatic brain injury (TBI) patients in the early postoperative stage.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed the clinical data of TBI patients who underwent craniotomy or decompressive craniectomy. Generalized additive mixed model (GAMM) was used to analyze effects of propofol and sevoflurane on Glasgow Coma Scale (GCS) on postoperative days 1,3, and 7. Multivariate regression analysis was used to analyze effects of the two anesthetics on Glasgow Outcome Scale (GOS) at discharge.</p></div><div><h3>Results</h3><p>A total of 340 TBI patients were enrolled in this study. There were 110 TBI patients who underwent craniotomy including 75 in the propofol group and 35 in the sevoflurane group, and 134 patients who underwent decompressive craniectomy including 63 in the propofol group and 71 in the sevoflurane group. It showed no significant difference in GCS at admission between the propofol and the sevoflurane groups among craniotomy patients (<em>β</em> = 0.75, 95%<em>CI</em>: –0.55 to 2.05, <em>p</em> = 0.260). However, elevation in GCS from baseline was 1.73 points (95%<em>CI</em>: –2.81 to –0.66, <em>p</em> = 0.002) less in the sevoflurane group than that in the propofol group on postoperative day 1, 2.03 points (95%<em>CI</em>: –3.14 to –0.91, <em>p &lt;</em> 0.001) less on day 3, and 1.31 points (95%<em>CI</em>: –2.43 to –0.19, <em>p</em> = 0.022) less on day 7. The risk of unfavorable GOS (GOS 1,2, and 3) at discharge was higher in the sevoflurane group (<em>OR</em> = 4.93, 95%<em>CI</em>: 1.05 to 23.03, <em>p</em> = 0.043). No significant difference was observed among two-group decompressive craniectomy patients in GCS and GOS.</p></div><div><h3>Conclusions</h3><p>Compared to propofol, sevoflurane was associated with worse neurological recovery during the hospital stay in TBI patients undergoing craniotomy. This difference was not detected in TBI patients undergoing decompressive craniectomy.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 2","pages":"Pages 97-108"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9844548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction","authors":"Ya-Nan Zhao ,&nbsp;Jia-Ning Cui ,&nbsp;Xing-Hua Zhang ,&nbsp;Jin-Feng Li ,&nbsp;Shi-Min Chen ,&nbsp;Xiu-Zheng Yue ,&nbsp;Tao Li","doi":"10.24920/004120","DOIUrl":"10.24920/004120","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the impact of microvascular obstruction (MVO) on the global and regional myocardial function by cardiac magnetic resonance feature-tracking (CMR-FT) in ST-segment-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention.</p></div><div><h3>Methods</h3><p>Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1 - 7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study. Based on the presence or absence of MVO on late gadolinium enhancement images, patients were divided into groups with MVO and without MVO. The infarct zone, adjacent zone, and remote zone were determined based on a myocardial 16-segment model. The radial strain (RS), circumferential strain (CS), and longitudinal strain (LS) of the global left ventricle (LV) and the infarct, adjacent, and remote zones were measured by CMR-FT from cine images and compared between patients with and without MVO using independent-samples <em>t</em>-test. Logistic regression analysis was used to assess the association of MVO with the impaired LV function.</p></div><div><h3>Results</h3><p>A total of 157 STEMI patients (mean age 56.66 ± 11.38 years) were enrolled. MVO was detected in 37.58% (59/157) of STEMI patients, and the mean size of MVO was 3.00 ±3.76 mL. Compared with patients without MVO (<em>n</em> = 98), the MVO group had significantly reduced LV global RS (<em>t</em> = −4.30, <em>P</em> &lt; 0.001), global CS (<em>t</em> = 4.99, <em>P</em> &lt; 0.001), and global LS (<em>t</em> = 3.51, <em>P</em> = 0.001). The RS and CS of the infarct zone in patients with MVO were significantly reduced (<em>t</em> = −3.38, <em>P</em> = 0.001; <em>t</em> = 2.64, <em>P</em> = 0.01; respectively) and the infarct size was significantly larger (<em>t</em> = 8.37, <em>P</em> &lt; 0.001) than that of patients without MVO. The presence of LV MVO [<em>OR</em> = 4.10, 95%<em>CI</em>: 2.05 – 8.19, <em>P</em> &lt; 0.001) and its size [<em>OR</em> = 1.38, 95% <em>CI</em>: 1.10–1.72, <em>P</em>=0.01], along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis, while only heart rate (<em>OR</em>=1.08, 95%<em>CI</em>: 1.03 – 1.13, <em>P</em>=0.001) and LV infarct size (<em>OR</em>=1.10, 95%<em>CI</em>: 1.03 - 1.16, <em>P</em>=0.003) were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.</p></div><div><h3>Conclusion</h3><p>The infarct size was larger in STEMI patients with MVO, and MVO deteriorates the global and regional LV myocardial function.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 11-19"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9319368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panscleritis After Blunt Ocular Trauma in A Child with Epididymitis","authors":"Yi-Nan Liu ,&nbsp;Yi-Ning Guo ,&nbsp;Yi-Fan Song ,&nbsp;Yan-Jie Tian ,&nbsp;Xue-Min Li","doi":"10.24920/004150","DOIUrl":"10.24920/004150","url":null,"abstract":"<div><p>We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground. Etiologic diagnosis played a key role in this case. Systemic examinations ruled out systemic autoimmune diseases, tumors, and infections as the cause of scleritis and suggested that the disease was caused by a local delayed-type hypersensitivity (DTH) induced by ocular trauma and was non-infectious. Still, the right epididymitis was infectious. Both conditions were treated successfully using steroids and antibiotics, respectively. Thus, early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 57-61"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9311108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Significant Genes and Pathways in Esophageal Cancer Based on Gene Expression Omnibus Database","authors":"An-Yi Song ,&nbsp;Lan Mu ,&nbsp;Xiao-Yong Dai ,&nbsp;Li-Jun Wang ,&nbsp;Lai-Qiang Huang","doi":"10.24920/004148","DOIUrl":"10.24920/004148","url":null,"abstract":"<div><h3>Objective</h3><p>To screen antigen targets for immunotherapy by analyzing over-expressed genes, and to identify significant pathways and molecular mechanisms in esophageal cancer by using bioinformatic methods such as enrichment analysis, protein-protein interaction (PPI) network, and survival analysis based on the Gene Expression Omnibus (GEO) database.</p></div><div><h3>Methods</h3><p>By screening with highly expressed genes, we mainly analyzed proteins MUC13 and EPCAM with transmembrane domain and antigen epitope from TMHMM and IEDB websites. Significant genes and pathways associated with the pathogenesis of esophageal cancer were identified using enrichment analysis, PPI network, and survival analysis. Several software and platforms including Prism 8, R language, Cytoscape, DAVID, STRING, and GEPIA platform were used in the search and/or figure creation.</p></div><div><h3>Results</h3><p>Genes <em>MUC13</em> and <em>EPCAM</em> were over-expressed with several antigen epitopes in esophageal squamous cell carcinoma (ESCC) tissue. Enrichment analysis revealed that the process of keratinization was focused and a series of genes were related with the development of esophageal cancer. Four genes including <em>ALDH3A1, C2, SLC6A1,</em> and <em>ZBTB7C</em> were screened with significant <em>P</em> value of survival curve.</p></div><div><h3>Conclusions</h3><p>Genes <em>MUC13</em> and <em>EPCAM</em> may be promising antigen targets or biomarkers for esophageal cancer. Keratinization may greatly impact the pathogenesis of esophageal cancer. Genes <em>ALDH3A1, C2, SLC6A1,</em> and <em>ZBTB7C</em> may play important roles in the development of esophageal cancer.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 20-28"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9321891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Dexmedetomidine on Maintaining Perioperative Hemodynamic Stability in Elderly Patients: A Systematic Review and Meta-analysis","authors":"Li-Juan Tian ,&nbsp;Yun-Tai Yao ,&nbsp;Su Yuan ,&nbsp;Zheng Dai","doi":"10.24920/004088","DOIUrl":"10.24920/004088","url":null,"abstract":"<div><h3>Objective</h3><p>Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia. Here we performed a systematic review and meta-analysis to evaluate the effect of dexmedetomidine on maintaining perioperative hemodynamic stability in elderly patients.</p></div><div><h3>Methods</h3><p>PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched for randomized-controlled trials (RCTs) on the application of dexmedetomidine in maintaining perioperative hemodynamic stability in elderly patients from their inception to September, 2021. The standardized mean differences (SMD) with 95% confidence interval (CI) were employed to analyze the data. The random-effect model was used for the potential clinical inconsistency.</p></div><div><h3>Results</h3><p>A total of 12 RCTs with 833 elderly patients (dexmedetomidine group, 546 patients; control group, 287 patients) were included. There was no significant increase in perioperative heart rate (HR), mean arterial pressure (MAP), and diastolic blood pressure (DBP) in the dexmedetomidine group before and during the operation. In addition, the variations of hemodynamic indexes including HR, MAP, SBP (systolic blood pressure), and DBP were significantly lower in the dexmedetomidine group compared with the control group (HR: SMD = −0.87, 95% <em>CI</em>: −1.13 to −0.62; MAP: SMD = −1.12, 95% <em>CI</em>: −1.60 to −0.63; SBP: SMD = −1.27, 95% <em>CI</em>: −2.26 to −0.27; DBP: SMD = −0.96, 95% <em>CI</em>: −1.33 to −0.59). Subgroup analysis found that with the prolongation of 1.0 μg/kg dexmedetomidine infusion, the patient's heart rate declined in a time-dependent way.</p></div><div><h3>Conclusion</h3><p>Dexmedetomidine provides more stable hemodynamics during perioperative period in elderly patients. However, further well-conducted trials are required to assess the effective and safer doses of dexmedetomidine in elderly patients.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 1-10"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9318327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intelligent Electrocardiogram Analysis in Medicine: Data, Methods, and Applications","authors":"Yu-Xia Guan ,&nbsp;Ying An ,&nbsp;Feng-Yi Guo ,&nbsp;Wei-Bai Pan ,&nbsp;Jian-Xin Wang","doi":"10.24920/004160","DOIUrl":"10.24920/004160","url":null,"abstract":"<div><p>Electrocardiogram (ECG) is a low-cost, simple, fast, and non-invasive test. It can reflect the heart's electrical activity and provide valuable diagnostic clues about the health of the entire body. Therefore, ECG has been widely used in various biomedical applications such as arrhythmia detection, disease-specific detection, mortality prediction, and biometric recognition. In recent years, ECG-related studies have been carried out using a variety of publicly available datasets, with many differences in the datasets used, data preprocessing methods, targeted challenges, and modeling and analysis techniques. Here we systematically summarize and analyze the ECG-based automatic analysis methods and applications. Specifically, we first reviewed 22 commonly used ECG public datasets and provided an overview of data preprocessing processes. Then we described some of the most widely used applications of ECG signals and analyzed the advanced methods involved in these applications. Finally, we elucidated some of the challenges in ECG analysis and provided suggestions for further research.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 38-48"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9314183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blue Nevus Hidden within the Nevus of Ota","authors":"Xing Liu ,&nbsp;Hui-Ying Zheng ,&nbsp;Fu-Min Fang ,&nbsp;He-Dan Yang ,&nbsp;Hui Ding ,&nbsp;Yin Yang ,&nbsp;Yi-Ping Ge ,&nbsp;Tong Lin","doi":"10.24920/004092","DOIUrl":"10.24920/004092","url":null,"abstract":"<div><p>A 3-year-old boy presented with bluish patch and scattered blue spots on the left side of his face. After several sessions of laser treatment, the azury patch in the periorbital area became even darker. Histopathology showed many bipolar, pigment-laden dendritic cells scattered in the papillary and upper reticular dermis. Immunohistochemically, these cells were positive for S100, SOX-10, melan-A, P16, and HMB-45. The positive rate of Ki-67 was less than 5%. Finally, the lesion was diagnosed with nevus of Ota concurrent with common blue nevus. Therefore, for cases of the nevus of Ota with poor response to laser treatment, the possible coexisting diseases should be suspected.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 70-72"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizing Pneumonia in A Patient Double-Positive for ANCA and Anti-GBM Antibodies: A Case Report","authors":"Fang-Yuan Wang ,&nbsp;Xiang-Ning Yuan ,&nbsp;Dan-Ni Sun ,&nbsp;Gong Xiao ,&nbsp;Cheng-Huan Hu ,&nbsp;Zhong-Hua Liao ,&nbsp;Jian-Ping Ning ,&nbsp;Hui Xu ,&nbsp;Jun-Tao Feng ,&nbsp;Hong-Ling Yin ,&nbsp;Xiao-Zhao Li","doi":"10.24920/004161","DOIUrl":"10.24920/004161","url":null,"abstract":"<div><p>Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 66-69"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9320180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Typhoidal Cells” Appear in a Woman with Hemophagocytic Syndrome Secondary To Brucellosis: A Case Report","authors":"Wei-Qing Song ,&nbsp;Xu Zheng ,&nbsp;Hai-Ni Li ,&nbsp;Li Li ,&nbsp;Jiang-Shui Yuan ,&nbsp;Shu-Guo Wang","doi":"10.24920/004152","DOIUrl":"10.24920/004152","url":null,"abstract":"<div><p>We report a case of hemophagocytic syndrome (HPS) secondary to brucellosis, in which typhoidal cells were found in bone marrow, suggesting typhoidal cells present not only in <em>Salmonella typhi</em> infections but also in other bacterial infections. Typhoidal cells in bone marrow can be used to quickly identify the presence of bacterial infection pending the results of bone marrow and/or blood cultures.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 62-65"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Medical Treatment of Primary Aldosteronism","authors":"Ying-Jie Li,&nbsp;Zhi-Gang Ji,&nbsp;Jin Wen","doi":"10.24920/004137","DOIUrl":"10.24920/004137","url":null,"abstract":"<div><p>Primary aldosteronism (PA) is the most common form of secondary hypertension, with its main manifestations including hypertension and hypokalemia. Early identification of PA is extremely important as PA patients can easily develop cardiovascular complications such as atrial fibrillation, stroke, and myocardial infarction. The past decade has witnessed the rapid advances in the genetics of PA, which has shed new light on PA treatment. While surgery is the first choice for unilateral diseases, bilateral lesions can be treated with mineralocorticoid receptor antagonists (MRAs). The next-generation non-steroidal MRAs are under investigations. New medications including calcium channel blockers, macrophage antibiotics, and aldosterone synthase inhibitors have provided a new perspective for the medical treatment of PA.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 1","pages":"Pages 49-56"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9320727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}